Glucose is an important source of energy to the cells in the human body and is abundantly present in food ingredients. After consumption of starch or other dietetic available sources of glucose and their subsequent digestion, glucose is released in the gastro-intestinal tract, where it is rapidly and effectively absorbed from the intestinal lumen. This will usually increase glucose concentrations in blood. The change in glucose after consumption of a food is called the postprandial glucose response (PPGR), which can be measured as the area under the curve (AUC), which plots the plasma glucose concentration with time. The human body strives to maintain homeostasis of glucose levels in tissue and blood with time, in order to allow proper functioning of all cells. One important instrument to achieve glucose homeostasis is the release of insulin by the pancreas when the concentration of specific food components like glucose starts to increase. Under normal circumstances this will increase glucose transport into the cell and the formation of glycogen using glucose, and trigger other metabolic changes, therewith rapidly causing the blood glucose levels to decrease to normal levels.
A person that does not react properly on released insulin is said to be insulin-resistant. Large groups of persons suffer from insulin resistance like many obese persons, persons suffering from the so called metabolic syndrome (or syndrome X), diabetics and many patients in hospitals or nursing homes who developed a temporarily or longer lasting insulin resistance as a cause of their disease. Part of the diabetics also experience an insufficient capacity to increase insulin concentrations in blood after consumption of food (called post-prandially). Persons that suffer from insulin-resistance demonstrate abnormal high postprandial glucose response, even after consumption of moderate amounts of food ingredients that comprise glucose. When high postprandial glucose concentrations occur relatively frequently and over longer periods of time, they can cause several severe health problems. Known secondary side effects, as can be found in diabetics, are problems in the cardio-vascular system, such as hypertension, athero-sclerosis, bad blood supply to peripheral tissues, stroke, heart attacks etc., as well as problems in the kidney, in particular an abnormal glomerular filtration rate, and a wide range of neuropathies and retinopathies like cataract. It was also found that mortality of severe disease in hospital patients is associated with the severity of insulin resistance.
The decrease of postprandial glucose response (PPGR) has been the subject of numerous research efforts. Many types of carbohydrates have been proposed to induce a low PPGR. Also inclusion of dietetic fibre in parental a nutritional product has been proposed for this purpose, for example viscous fibres, like gums or pectin. The disadvantage of using such fibres is the increase in viscosity, leading to bloating, flatulence, loss of appetite and possibly constipation, when used in liquid products in amounts that are effective.
DE 3935906 discloses the use of galactose for the nutrition of metabolically stressed patients, e.g. suffering from diabetes mellitus. Other saccharides such as glucose, mannose, N-acetylglucosamine, N-acetylgalactosamine, fucose, fructose or lactulose may also be present, although it is preferred that galactose represents at least 50% or even at least 75% of the saccharides. Amino acids, salts etc. are also included in the parenteral administration.
WO03/104473 discloses the galactosylation of hydrogenated and non-hydrogenated isomaltulose to produce oligosaccharides that are useful as probiotics. They are also to be useful for modulating glycemic properties of food products.
WO04/081022 describes a grain composition containing prebiotic isomalto-oligosaccharides obtained by transglucosylation of maltose. The composition can be used for various purposes, including a baking ingredient and an oral rehydration solution.
EP-A 1229803 by Stahl also discloses specific synthetic oligosaccharides obtained by trans-glucosylation, that are slowly digestible.
WO 01/17370 discloses the use of trehalose for providing nutrition to persons suffering from disorders of insulin metabolism. The trehalose replaces other sugars, such as sucrose, glucose and maltose, which should be substantially absent.
It is an object of the invention to provide a nutritional product that is effective in rapidly providing glucose to the consumer and maintaining a clinically significant supply of glucose during a prolonged time without resulting in undesirably high concentrations of glucose in the blood, even in persons that have become insulin-resistant.
It is a further object of the invention to a provide nutritional product for persons that suffer from insulin resistance, in order to prevent development of disorders which result from prolonged and frequent high levels of glucose in blood, such as those diseases that result from advanced glycation products (AGE), neuropathies, retina problems, and kidney problems.